Veterinarians may ignore signs of compassion fatigue

It's not just any review that popped up on Yelp. It's a scathing diatribe full of personal attacks on you and your team. And you've been reading and rereading it in the minutes between appointments.

GETTY IMAGSE/MARTIN DIMITROV

Sound familiar? The seemingly endless cycle of bills, problems and just plain bad days in a veterinary hospital can make the callous opinions of others the last straw. And the emotional toll they take can leave veterinarians—who often care deeply about such things—susceptible to compassion fatigue and depression.

This has perhaps never been more evident in veterinary medicine than since the suicide of New York veterinarian Shirley Koshi, DVM, in February (see the April issue of dvm360). Still fresh in the minds of the profession, this tragedy has prompted experts to urge the profession to take veterinarians' emotional health seriously.

Before you write off the idea of compassion fatigue as the need for more "balance," disregard that headache you can't shake or even try to ignore those ever-more-intrusive feelings of hopelessness, you should know that denial is as common as compassion fatigue itself.

To prevent it, or heal from it, says Patricia Smith, author of To Weep for a Stranger: Compassion Fatigue in Caregiving, you have to recognize the problem. "Compassion fatigue is real. It is a secondary stress syndrome," she says. "Everybody thinks compassion fatigue is you're tired of giving—it's not. It's work-related trauma every day."

And veterinarians are prime candidates. Jennifer Brandt, PhD, a licensed social worker at The Ohio State University College of Veterinary Medicine, says people who work in caring professions are often empathetic individuals and highly susceptible to compassion fatigue. In other words, the same qualities that make great veterinarians are the same qualities that can tank them. "One's capacity for empathy and compassion increases the risk for compassion fatigue," Brandt says.

She says common symptoms include intrusive negative thoughts, physical problems such as GI issues, headaches and lethargy—even being accident-prone. There are also spiritual indicators, such as a loss of hope, questioning life in general, questioning one's contribution, skepticism and excessive guilt.

Brandt says veterinarians and team members should also pay attention to signs in coworkers: anxiety, anger, sadness, hypersensitivity or numbness, irritability or depression. "It's really going to be in the nonverbal clues," she says.

Unfortunately, many people in the veterinary profession try to muscle through compassion fatigue, but the symptoms mount until it becomes overwhelming, Smith says. "Some people can go for years and then it can hit them," she says. "Or it can happen in a month."

Veterinarians who are practice owners and bosses are especially good at hiding their symptoms because they don't want to appear weak, Smith says. Loneliness from the isolation this creates eventually sets in, and that feeds the trauma. Smith says this is especially hard for sole practitioners who are socially and geographically isolated.

A major part of the solution is a support system. When Smith worked as the manager of an animal shelter in 2000, she didn't feel like she could share her feelings with her family or friends. "They didn't want to hear about my experience—they're all animal lovers—and I was so used to sharing with them," she says. The solitude in her grief over what she witnessed at the shelter convinced her of the need for human support.